• Use consistent method for K reading measurements both pre, and postoperatively
• Identify corneal irregularities using topography
• Utilize the TECNIS ® Toric IOL calculator to determine the appropriate toric model and
• power
• Print Calculator results for reference in theatre
• Before draping for surgery, make reference marks near the limbus of the operative eye in two locations, 180° (ie, 3 and 9 o’clock), when patient is upright to avoid the effects of cyclorotation and to aid with inoperative axis alignment

INTRAOPERATIVE CONSIDERATIONS

• Use the Toric calculator results to verify TECNIS ® Toric IOL model, power and desired axis placement
• Identify and mark the steep axis of the cornea using an axis gauge of your choice and the preoperative reference mark
• After IOL implantation, align the anterior surface markings of the IOL (four small dots) with the steep axis markings of the cornea for optimal correction of cylinder error

AXIS ALIGNMENT

GROSS ALIGNMENT. Following lens implantation in the capsular bag, rotate the IOL clockwise until it is approximately 10 to 15 degrees before the calculated positionVISCOELASTIC REMOVAL. During OVD removal with the preferred technique, rotate the IOL clockwise until it is precisely aligned with the final calculated FINAL ALIGNMENT. Using your preferred technique, rotate the IOL clockwise until it is precisely aligned with the final calculated position.

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